耳塞和眼罩对心脏加强监护病房行冠状动脉旁路移植术患者谵妄严重程度和睡眠质量的疗效：一项单盲、随机对照试验。

The efficacy of earplugs and eye masks for delirium severity and sleep quality in patients undergoing coronary artery bypass grafting in cardiac intensive care units: A single-blind, randomised controlled trial.

机构信息

Traditional and Complementary Medicine Research Center, Addiction Institute, Mazandaran University of Medical Sciences, Sari, Iran; Adjunct Research Fellow, Flinders University, Adelaide, Australia.

Student Research Committee, School of Nursing and Midwifery, Mazandaran University of Medical Sciences, Sari, Iran.

出版信息

Aust Crit Care. 2024 Jan;37(1):74-83. doi: 10.1016/j.aucc.2023.08.003. Epub 2023 Oct 4.

DOI:10.1016/j.aucc.2023.08.003

PMID:37802695

Abstract

BACKGROUND AND PURPOSE

Delirium is a neuropsychiatric syndrome with a wide range of possible causes and multiple complications in patients admitted to intensive care units. It is, therefore, necessary to seek appropriate and safe strategies to prevent and manage delirium. This study is intended to examine the efficacy of eye masks and earplugs for delirium severity and sleep quality in patients with coronary artery bypass grafting in a cardiac intensive care unit.

MATERIALS AND METHODS

This single-blind, randomised controlled trial was conducted on 114 patients who were consecutively enrolled and randomly assigned to either the experimental group or the control group. The experimental group received routine care plus eye masks and earplugs, and the control group received only routine care. The delirium severity and sleep quality were measured with the Neelon and Champagne confusion scale and the Verran and Snyder-Halpern sleep scale.

RESULTS

The mean delirium severity score differed significantly between the two groups on the second, third, and fourth postoperative days (p < 0.001). Although the trend of changes in the mean delirium severity score from the first postoperative day (before the intervention) to the second, third, and fourth postoperative days was downward in the two groups (trending towards higher delirium severity), the control group experienced greater changes than the experimental group. An intragroup analysis of delirium severity detected a statistically significant difference in both the experimental and control groups (p < 0.001). The sleep quality domains (sleep disturbance, sleep effectiveness, sleep supplementation) showed a statistically significant difference between the two groups across the three intervention days (p < 0.001).

CONCLUSION

The overnight use of eye masks and earplugs were found to have positive effects on sleep quality domains (sleep disturbance, sleep effectiveness, sleep supplementation) and delirium severity in coronary artery bypass grafting patients admitted to the cardiac intensive care unit for several days. It was also found that a significant interaction effect between the sleep disturbance subscale and delirium severity exists.

CLINICAL TRIAL REGISTRATION NUMBER

(https://en.irct.ir): IRCT20210523051370N2.

摘要

背景与目的

谵妄是一种神经精神综合征，其病因广泛，重症监护病房（ICU）患者并发症众多。因此，有必要寻求适当且安全的策略来预防和管理谵妄。本研究旨在探讨在心脏 ICU 接受冠状动脉旁路移植术的患者中使用眼罩和耳塞对谵妄严重程度和睡眠质量的影响。

材料与方法

这是一项单盲、随机对照试验，共纳入 114 例连续患者，并随机分为实验组和对照组。实验组接受常规护理加眼罩和耳塞，对照组仅接受常规护理。采用 Neelon 和 Champagne 混乱量表和 Verran 和 Snyder-Halpern 睡眠量表评估谵妄严重程度和睡眠质量。

结果

术后第 2、3、4 天，两组间的平均谵妄严重程度评分差异有统计学意义（p<0.001）。尽管两组从术后第 1 天（干预前）到第 2、3、4 天的平均谵妄严重程度评分变化趋势均呈下降趋势（即谵妄严重程度呈上升趋势），但对照组的变化幅度大于实验组。组内分析显示，实验组和对照组的谵妄严重程度均有统计学差异（p<0.001）。睡眠质量各领域（睡眠障碍、睡眠效果、睡眠补充）在 3 个干预日之间，两组间差异有统计学意义（p<0.001）。